This one is very complicated. I have an Rx for and use testosterone cream. In all reality at this point I would prefer to take injectable, but that is for a different thread.
A few months ago I had a major physical relating to my hormone panels. I was finally able to use an MD friend who I knew was very competent in this area.
According to what he told me:
Testosterone is only part of a picture. There are actually a multitude of hormones which make up a "package". If testosterone is high and estrogen is also above normal levels the effects of the testosterone are as a whole compromised. Another hormone in a male that can compromise erections is prolactin. If prolactin is high or higher than it should be it compromises erection quality not allowing the erection to reach it's full potential.
If one wanted a PE environment the first thing one would have to have would be a panel with the lowest possible levels of estrogen and prolactin. Remember that some teens suffer from a condition called gynecomastia (breast development) as they pass through puberty. This condition is brought about by increases in both prolactin and estrogen in addition to testosterone. If those unnecessary hormones which do not exist in everyone were eliminated it might result in changes in development. The idea to create an increase would be to restore function and upgrade androgen receptors in the penile tissues. As we age these receptors "burn out" and even with higher hormone levels the ability of these tissues to respond is not the same as it was when we were teens, it is in fact compromised.
In my own case, I have had some interesting discoveries. Three years ago I went on intracavernosal injections for ED. When this MD looked at everything he said that he was going to renew my injectable, but, that after the hormones were normalized that I would notice at least a dramatic improvement. This is in fact what happened. I can now get by very easily on low dose tadalafil (Cialis) for the most part. I can achieve penetration without the shot, but there are times that the shot provides additional benefits.
There is also a difference in erections. When I use injectable my erections are not only noticeably, but, measurably larger. With no medication I can use one of the best cock rings on the planet (hardwear) and it fits easily, and helps a great deal. Using tadalifil I can still use the "hardwear" but it is a bit tight. If I do an IC injection I cannot even begin to fit into the the "hardwear" because my erection is that much larger. If I put on the "hardwear" ring and then inject as the erection comes up I have to take the ring off because it gets really painful.
The only way that the use of exogenous testosterone in any form would have a positive effect would be if the androgen receptors in the tissue could be revived.
The only thing that might be effective at all could be direct high potency injections into the penis of DHT. These would have to be given in numbers and as "sub-Q" to have a chance of working. This would eliminate the 5ar conversion and would stand some chance of being high enough in intensity to find any active receptors in the tissues and maybe get some response.
The problem is that injectable DHT has a very short life and the injections would have to be done either daily or every other day. One would literally have to turn their penis into a pin cushion and this would have to go on for a period of time.
Remember that cellular growth takes time, and that it would probably take some time before one actually knew if it was going to work or not.
